NIH-funded study highlights importance of cholesterol testing and education

More than 70% of American Indian youth ages 20 to 39 and more than 50% of American Indian teens have elevated blood cholesterol levels or fats that put them at risk for cardiovascular disease. Research supported by the National Institutes of Health suggests that In some cases, these levels, especially high low-density lipoprotein (LDL) cholesterol, which is often thought of as “bad cholesterol,” have been linked to plaque buildup and cardiovascular events such as heart attacks and strokes. There may be.

The survey results are American Heart Association Journalare from a 19-year review of the Strong Heart Family Study, part of the largest study of cardiovascular health outcomes and risk factors in American Indian adults, the Strong Heart Study. Researchers followed more than 1,400 participants aged 15 to 39 from 2001-2003 to 2020. At the start of the study, 55% of participants aged 15 to 19 had abnormal cholesterol levels, as did 74% of participants aged 20 to 29. And 78% of them are between 30 and 39 years old.

“We were surprised by these numbers, especially among adolescents,” said Dr. Jessica A. Reese, an epidemiologist at the American Indian Health Research Center at the University of Oklahoma Health Science Center in Oklahoma City. “These findings demonstrate the importance of early screening and intervention, especially for teens and young adults who are more likely to have underlying cardiovascular risks, diabetes, or chronic liver disease. ”

Researchers defined cholesterol as abnormal if it was high or had high total cholesterol. High LDL cholesterol or other types of “bad” cholesterol. Moderately high triglycerides. Low HDL cholesterol, often considered “good cholesterol”. or whether they were prescribed cholesterol-lowering drugs.

About 40% of study participants had high LDL levels (at least 100 mg/dL), and nearly 3% had very high levels (at least 160 mg/dL). However, less than 2% of participants with very high LDL cholesterol were taking cholesterol-lowering drugs at the start of the study.

“This research supports efforts to identify ways to improve heart health and support younger generations of Native Americans, including enhanced testing and culturally relevant education.” said Mona Pugal, MPH, an epidemiologist in the Department of Cardiovascular Sciences. The Lung and Blood Institute (NHLBI), part of the NIH.

American Indian adults are twice as likely to suffer from heart disease compared to the general U.S. population. The abnormal cholesterol levels found among the study participants were also twice as high as those seen in the general population of U.S. teens and young adults. Researchers emphasized the value of regular check-ins and testing. All participants in the observational study were also informed of laboratory and imaging results after the physical exam, and the researchers encouraged them to take the results to their health care provider.

At the beginning of the study, 1,165 participants underwent ultrasound examinations of their carotid arteries (arteries in the neck that carry blood from the heart to the brain). Approximately 61 (5%) had plaque or signs of early plaque development. If too much plaque builds up in the arteries, it can block blood flow to the heart or rupture, potentially causing a stroke or requiring surgery.

Approximately 5.5 years after baseline measurements, 19 participants (approximately one-third of those with detected plaques) showed signs of worsening plaques. Of his 1,104 patients who initially had no detectable plaque, 109 (10%) had signs of plaque at his second check-in. Researchers linked high levels of LDL cholesterol, total cholesterol, and other non-HDL cholesterol to these outcomes.

By the end of the study, approximately 127 participants (9%) had experienced a heart attack, stroke, heart failure, or related cardiac surgery or death. Participants with diabetes and at least some cardiovascular risks (such as large waistlines, high blood sugar, high triglycerides, high blood pressure, and low HDL cholesterol) were also more likely to have cardiovascular events.

To help detect risks early, the researchers emphasized the importance of adolescents staying connected to their health care providers.

“It’s important for everyone to work with their doctor to check their blood cholesterol and blood sugar levels annually. This will help support a healthy life later in life,” says the Center for American Indian Health Research. said Director Ying Chan, MD. At the University of Oklahoma Health Sciences Center. “As adolescents grow from pediatrician visits to adult health care providers, it’s also important to coordinate their annual care.”

For more information about cholesterol and heart health, visit https://www.nhlbi.nih.gov/resources/cholesterol-your-heart-what-you-need-know-fact-sheet.

This study was funded by NHLBI.

Research: Reese JA, Roman MJ, Deen JF, et al. Dyslipidemia in young American Indians: A study of strong heart families. J. Am Hart Association 2024; doi: 10.1161/JAHA.123.031741.